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Objective:To explore the pathogenesis and treatment of severe hematuria after sexual activity in men.Methods:A retrospective analysis of 10 patients with severe hematuria after sexual activity who were admitted from January 2017 to January 2020, including 4 cases from Peking University People’s Hospital, 3 cases from Donghua Hospital Affiliated to Sun Yat-sen University, 2 cases from Second Hospital of Tianjin Medical University, and 1 case from Tianjin Jinnan Hospital. The average age of the patients was (33.5±7.6) years old. All 10 cases had severe hematuria and blood clots within 1 hour after sexual activity. The blood routine examination revealed that there were different degrees of hemorrhagic anemia after 24 hours of admission, and the average hemoglobin was(95.8±8.9)g/L. Ten patients underwent transurethral cystoscopy electrosurgical resection and / or electrocoagulation under subarachnoid anesthesia or epidural anesthesia. All patients were confirmed to be bleeding from posterior urethral lesions, including 4 cases located in the distal seminal caruncle, 5 cases in the prostate, and 1 case in proximal seminal caruncle. Three cases whose bleeding from varicose veins in the prostate urethra were treated with electrocoagulation in order to stop the bleeding, and lesions were removed in the other 7 cases for pathological examination. The F16 urinary catheter was indwelt after the operation.Results:All 10 operations in this group were successfully completed. Six cases of posterior urethral hemangioma rupture and 1 case of posterior urethral polyp were confirmed by the pathological examination in 7 cases. The urinary catheter was successfully removed 1 week after operation. Abstinence was required for 1 month after operation. There was no recurrence of hematuria after resuming sexual activity, and no complications such as dysuria or urinary incontinence.Conclusion:Severe hematuria after sexual activity is mostly caused by rupture or bleeding of abnormal blood vessels in the posterior urethra. Transurethral resection and/or electrocoagulation are the first choice for treatment. The effect is reliable and the prognosis is satisfactory.
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Objective To systematically evaluate the prognostic significance of lymphovascular invasion (LVI) in pT1 stage bladder urothelial carcinoma with squamous differentiation. Methods The clinical and patholog-ical data of 105 patients with pT1 stage urothelial carcinoma with squamous differentiation and transurethral resec-tion of bladder tumor (TURBT) were retrospectively analyzed. Hematoxylin-eosin staining and immunohistochemical staining were used to determine the presence of LVI in tumor tissues. All patients were divided into LVI-negative group and LVI-positive group according to LVI. The relationship between LVI and clinicopathological features and 5-year cancer-specific survival (CSS) rate was analyzed. Patients with relapse were divided into TURBT group and radi-cal cystectomy (RC) group according to the surgical method, and the effects of the methods on CSS were compared. Results There are 57 patients (27.6％) had LVI. In the LVI-negative group, the 5-year CSS was 84.9％, while that in the LVI-positive group was 58.4％, the difference was statistically significant(P<0.05). Univariate analysis showed that tumor multiple appearance, tumor size, recurrence and LVI were significantly correlated with CSS (all P<0.05). Multivariate analysis showed that tumor size and LVI had significant effects on CSS (all P<0.05). In the relapsed pa-tients with LVI-positive, RC had a higher CSS than TURBT (P=0.042). In the relapsed patients with LVI-negative, the difference between the two methods was not statistically significant (P=0.692). Conclusions LVI is an important prognostic factor in pT1 stage urothelial carcinoma with squamous differentiation. Patients with LVI and tumor size>3 cm have a higher risk of death. Patients with pT1 stage urothelial carcinoma with squamous differentiation, espe-cially those with LVI, should be treated with RC as soon as possible.
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Objective@#To introduce a self-developed bone dust collector designed by the authors and evaluate its efficiency in mastoid obliteration following mastoidectomy.@*Methods@#Consecutive patients, from April 2017 to March 2018, who prepared to receive mastoidectomy were randomly divided into two groups, and in each group the bone dust was harvested by self-developed bone dust collector or by conventional used method respectively in mastoidectomy. The amount of the harvested bone dust and the time consumed in the collecting procedure were compared between two groups. The infection of the bone dust after mastoid obliteration was also evaluated during follow up.@*Results@#33 patients were recruited in bone dust collector group, and 31 patients in conventional method group.There is no significance of difference between two groups in sex ratio, age and pneumatization of mastoid cells (P>0.05 for all). The median amount of bone dust harvested by bone dust collector was significantly larger than that collected by conventional method (1.8 g vs 1.1 g, P<0.05). The median time spent in bone dust collector group was significantly shorter than that spent in conventional method group (4 minutes vs 6 minutes, P<0.05). No bone dust infection was found in the follow-up in all patients.@*Conclusion@#The present self-developed bone dust collector is a easy and useful apparatus which can significantly improve the efficiency of collecting bone dust in mastoidectomy.
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Objective To investigate the clinical features,diagnosis,treatment and prognosis of bladder hemangio-ma. Methods The clinical data of 12 patients with bladder hemangioma were retrospectively reviewed and analyzed in com-bination with relevant literature. Results Ten patients were treated with partial cystectomy,and two patients treated with transurethral resection of bladder tumor (TUR-BT). All patients were diagnosed as the bladder hemangioma by postoperative pathology. Patients were followed up from 4 months to 6 years. There were no recurrence and metastasis in all cases. Conclu-sion Bladder hemangioma is a rare benign tumor, which can be preliminarily diagnosed by combinating with medical imag-ing. The final diagnosis depends on the pathological examination. Treatment options should rely on the factual situations. The partial cystectomy is the first choice for the treatment of bladder hemangioma. The prognosis is good.
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OBJECTIVE@#To explore the curative effect of endoscopic myringoplasty with modified sandwich technique.@*METHOD@#Endoscopic myringoplasty was performed with modified sandwich technique for traumatic perforation of tympanic membrane and chronic suppurative otitis media (simple type) of 43 patients.@*RESULT@#All the perforating tympanic membranes were repaired successfully in one time. Six months after the operation, 1 case was out of follow-up and 2 cases were failed: one got a small perforation when the transplantation shifted and the transplantation of the other one was lost because of infection. The closure rate of tympanic membrane perforations was 95.2%. The air-bone gap of speech frequency of 28 ears increased by > 15-20 dB, 8 ears were enhanced by 10-15 dB, while 6 ears (including 2 failed cases) without improvement. The acoustic immittance test showed that "Type A", "Type As", "Type Ad", "Type B" and "Type C" tympanogram were in 30 ears,12, 4, 6 and 4, respectively.@*CONCLUSION@#The endoscopic myringoplasty with modified sandwich technique has the advantages of simple operation, better security, less trauma and better efficacy, and it is worth popularizing.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Ear , General Surgery , Endoscopy , Myringoplasty , Methods , Tympanic Membrane Perforation , General SurgeryABSTRACT
OBJECTIVE@#To analyze the reasons and hazards of the misdiagnosis and erroneous treatment for airway foreign body in children, and explore the effective measures.@*METHOD@#To analyze 452 cases of airway foreign body with the history of misdiagnosis in children.@*RESULT@#The medical history and objective signs could be helpful to the diagnosis of airway foreign body. X ray examination is nessesary and useful, meanwhile, CT and multiple plane reconstruction provide another choice for the diagnosis.@*CONCLUSION@#Doctors should recognize the hazards of delayed diagnosis of airway foreign body and avoid the misdiagnosis and erroneous treatment. Suitable time of intervention and surgical approach could decrease the complications and elevate healing rate.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Diagnostic Errors , Foreign Bodies , Diagnosis , Therapeutics , Respiratory SystemABSTRACT
Objective:To develop an enzyme immunoassay for the detection of Osteogenic Growth Peptide in serum for clinical investigation.Methods:Two kinds of competitive Enzyme linked immununosorbent assay were employed,based on sensitivity and shape of dose-reaction curve,the most suitable testing pattern was selected for further application.Results:Purified antibody was better than salting-out antibody in competitive Enzyme linked immununosorbent assay in terms of standard curve.Modified competitive Enzyme linked immununosorbent assay was better than competitive Enzyme linked immununosorbent assay in sensitivity.Conclusion:Modified competitive Enzyme linked immununosorbent assay for Osteogenic Growth Peptide is sensitive enough for clinical investigation.